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A client with a cold is taking the antitussive benzonatate (Tessalon). Which assessment data indicates to the nurse that the medication is effective?
- A. Reports reduced nasal discharge.
- B. Denies having coughing spells.
- C. Able to sleep through the night.
- D. Expectorating bronchial secretions.
Correct Answer: B
Rationale: The correct answer is B: Denies having coughing spells. Benzonatate is an antitussive medication that suppresses cough reflex. If the client denies having coughing spells, it indicates that the medication is effectively suppressing the cough. This is the most direct indicator of the medication's effectiveness.
A: Reports reduced nasal discharge - This is not directly related to the effectiveness of benzonatate in suppressing cough.
C: Able to sleep through the night - While improved sleep may result from reduced coughing, it is not as specific an indicator of antitussive effectiveness as denying coughing spells.
D: Expectorating bronchial secretions - This indicates productive coughing, which is not the intended effect of benzonatate.
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A client with a history of deep vein thrombosis (DVT) is receiving warfarin (Coumadin). Which laboratory value indicates a therapeutic effect of the medication?
- A. INR of 2.5.
- B. PTT of 45 seconds.
- C. Hemoglobin of 12 g/dL.
- D. Platelet count of 150,000/mm³.
Correct Answer: A
Rationale: The correct answer is A: INR of 2.5. INR (International Normalized Ratio) is used to monitor the effectiveness of warfarin therapy. A target INR range for DVT treatment is typically 2.0-3.0. An INR of 2.5 indicates that the client's blood is clotting within the desired therapeutic range, preventing excessive clotting while avoiding excessive bleeding.
B: PTT measures the effectiveness of heparin, not warfarin.
C: Hemoglobin level and D: Platelet count are not specific indicators of warfarin's therapeutic effect on clotting factors.
In summary, the correct answer A is the most relevant laboratory value for monitoring the therapeutic effect of warfarin in a client with DVT.
When creating a care plan for a 70-year-old obese client admitted to the postsurgical unit following a colon resection, the client's age and increased body mass index put them at increased risk for which complication in the postoperative period?
- A. Hyperglycemia
- B. Azotemia
- C. Falls
- D. Infection
Correct Answer: D
Rationale: The correct answer is D: Infection. Postoperative obese patients are at higher risk for surgical site infections due to impaired wound healing, decreased tissue oxygenation, and increased tissue pressure. Obesity also compromises the immune system, further increasing susceptibility to infections. Age is a risk factor for infection as well, as older adults may have weakened immune responses. Hyperglycemia (choice A) is a common issue in obese patients but not specifically related to postoperative complications. Azotemia (choice B) refers to elevated levels of nitrogen-containing compounds in the blood and is not directly related to obesity or age. Falls (choice C) are more related to mobility issues and environmental factors, not specifically to age and obesity in the postoperative period.
A client reports recent exposure to hepatitis A. What is a common mode of transmission for this virus?
- A. Blood transfusion
- B. Fecal-oral route
- C. Needle sharing
- D. Sexual contact
Correct Answer: B
Rationale: The correct answer is B: Fecal-oral route. Hepatitis A is commonly transmitted through ingestion of contaminated food or water. The virus is present in the feces of infected individuals and can be spread through inadequate sanitation practices. Blood transfusion (A) is not a common mode of transmission for hepatitis A. Needle sharing (C) is more associated with hepatitis B and C transmission. Sexual contact (D) is not a primary mode of transmission for hepatitis A. In summary, the fecal-oral route is the most common mode of transmission for hepatitis A due to contamination of food or water with the virus.
A client with long-standing obesity has been prescribed phentermine/topiramate-ER. What statement by the client suggests that further health education is necessary?
- A. I'm so relieved to start this medication. I really don't like having to exercise or change what I eat.
- B. It's hard to believe that there are actually medications that can treat obesity.
- C. I'm a bit nervous to start this medication because I know I'll need blood tests sometimes.
- D. I'm going to have to do some rearranging of my finances to make sure I can afford this medication.
Correct Answer: A
Rationale: The correct answer is A because the client's statement indicates a lack of understanding about the comprehensive approach needed to address obesity. Phentermine/topiramate-ER is not a standalone solution; it is most effective when used in conjunction with lifestyle changes like exercise and dietary modifications. By expressing a dislike for exercise and dietary changes, the client demonstrates a reliance solely on the medication, which is not conducive to long-term weight management. This suggests a need for further education on the importance of holistic lifestyle modifications in conjunction with medication therapy.
Choice B is incorrect because the client expressing disbelief at medications for obesity is not necessarily indicative of a need for further education; it may simply reflect surprise or lack of awareness. Choice C is incorrect as the client's nervousness about blood tests is a common concern and does not necessarily indicate a need for more education. Choice D is also incorrect as financial concerns are valid but do not directly relate to the need for additional health education.
After undergoing rigid fixation for a mandibular fracture from a fight, what area of care should the nurse prioritize for discharge education for this client?
- A. Resumption of activities of daily living
- B. Pain control
- C. Promotion of adequate nutrition
- D. Strategies for promoting adequate nutrition
Correct Answer: C
Rationale: The correct answer is C because promoting adequate nutrition is crucial for optimal healing of mandibular fractures. Malnutrition can delay recovery and impair bone healing. The nurse should prioritize educating the client on ways to maintain a balanced diet, such as consuming foods rich in protein, vitamins, and minerals.
A: Resumption of activities of daily living is important, but nutrition is more critical for healing.
B: Pain control is essential, but ensuring proper nutrition is a higher priority for optimal recovery.
D: Strategies for promoting adequate nutrition is redundant and less specific compared to the correct answer.